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Comparison of Postoperative Stability Between BSSRO and Le Fort 1 Osteotomy with BSSRO in Skeletal Class III Malocclusion with Severe Open Bite

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Abstract

Introduction

We aimed to investigate postoperative stability after orthognathic surgery in patients with skeletal class III malocclusion with severe open bite by comparison between bilateral sagittal splitting osteotomy (BSSRO) and BSSRO with Le Fort 1 osteotomy.

Materials and methods

Seventeen patients with skeletal class III malocclusion with severe open bite who were needed more than 6 degree counterclockwise rotation of distal segment by only BSSRO in preoperative cephalometric prediction. The subjects were divided into group A, where 9 patients were treated by BSSRO, and group B, where 8 patients were treated by BSSRO with Le Fort 1 osteotomy. Patient’s characteristics of age, gender, preoperative over jet (OJ) and over bite (OB) were not found to be significantly different between the two groups. Counterclockwise rotation of distal segment in preoperative cephalometric prediction by only BSSRO was not found to be significantly different between group A of 7.6 (6–10.6) degree and group B of 9 (6–13) degree. The amount of rotation was reduced to 5.4 (3–10) degree by bimaxillary surgery using BSSRO and Le Fort 1 osteotomy in group B. OJ and OB were measured as occlusal stability factor. Distance between ANS-to-PNS plane and the edge of upper incisor (NF–U1Ed), and distance between Menton and edge of lower incisor (Me–L1Ed) were measured as skeletal stability factor using cephalometric analysis. These lengths were measured at pre-surgery (T0), 2 weeks after surgery (T1) and 1 year after surgery (T2), and these differences between the two groups were statistically analyzed.

Results

OJ and OB kept a good relation at any experimental periods. The change of Me–L1Ed was significantly larger in group A (1.21 mm at T0–T1, 1.02 mm at T0–T2) than in group B (0.14 mm at T0–T1, 0.16 mm at T0–T2). The change of NF–U1Ed was not significantly different between group A (1.07 mm at T0–T1, 0.57 mm at T0–T2) and group B (0.51 mm at T0–T1, − 0.05 mm at T0–T2).

Conclusion

In case with more than 6 degree counterclockwise rotation of distal segment, skeletal stability was better after bimaxillary surgery than only BSSRO; however, OJ and OB kept a good relation.

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Authors and Affiliations

  1. Oral and Maxillofacial Surgery, Department of Oral Patho-biological Science, Graduate School of Dental Medicine, Hokkaido University, Kita 13 Nishi 7 Kita-ku, Sapporo, Hokkaido, 060-8586, Japan

    Kazuhiro Ooi, Kazuhiro Matsushita, Hiro-o Yamaguchi, Tadashi Mikoya & Kanchu Tei

  2. Gerodontology, Department of Oral Health Science, Graduate School of Dental Medicine, Hokkaido University, Kita 13 Nishi 7 Kita-ku, Sapporo, Hokkaido, 060-8586, Japan

    Nobuo Inoue

  3. Department of Oral and Maxillofacial Surgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8641, Japan

    Kazuhiro Ooi & Shuichi Kawashiri

Authors
  1. Kazuhiro Ooi
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  2. Nobuo Inoue
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  3. Kazuhiro Matsushita
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  4. Hiro-o Yamaguchi
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  5. Tadashi Mikoya
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  6. Shuichi Kawashiri
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Contributions

KO and NI designed most of the experiments and wrote the main manuscript text and prepared all figures and tables. KM and HY are the primary persons responsible for carrying out all experimental procedures. TM analyzed the data. SK and KT are the persons who made the final approval of the article.

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Correspondence to Kazuhiro Ooi.

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The authors declare that they have no conflicts of interest.

Ethical approval

Approval was given by Hokkaido University Hospital Ethics Committee (Ref. No 010-0285).

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All patients are informed about research purpose and agree to use their clinical data for this study.

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Ooi, K., Inoue, N., Matsushita, K. et al. Comparison of Postoperative Stability Between BSSRO and Le Fort 1 Osteotomy with BSSRO in Skeletal Class III Malocclusion with Severe Open Bite. J. Maxillofac. Oral Surg. 19, 591–595 (2020). https://doi.org/10.1007/s12663-019-01300-2

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  • DOI: https://doi.org/10.1007/s12663-019-01300-2

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